A nurse is planning to transfer a client who weighs 136 kg (300 lb) from a bed to a chair. The client is unable to assist in the transfer. Which of the following actions should the nurse plan to take?

Choice A reason: Disulfiram is an oral medication, not injectable, used to deter alcohol consumption by causing adverse reactions. Monthly injections apply to drugs like naltrexone, not disulfiram, which requires daily oral dosing to maintain its deterrent effect in alcohol use disorder treatment.
Choice B reason: Taking disulfiram before quitting alcohol is incorrect, as it is started post-abstinence to prevent relapse. Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde buildup if alcohol is consumed, making it effective only in alcohol-free clients to deter drinking.
Choice C reason: Avoiding over-the-counter medications with alcohol is correct, as disulfiram causes severe reactions (nausea, flushing) with alcohol ingestion, including from medications like cough syrups. This reflects understanding of disulfiram’s mechanism, ensuring safety by preventing unintended alcohol exposure.
Choice D reason: Continuing disulfiram for 5 years is not standard, as duration varies per treatment plan. Disulfiram supports early abstinence, not fixed long-term use. This statement misrepresents its role, as therapy length depends on individual recovery needs, not a predetermined timeframe.

Choice A reason: Encouraging a final hemodialysis treatment contradicts the client’s advance directives, which refuse life-sustaining treatments. Respecting autonomy is paramount, and persuading the client undermines their decision, making this action unethical and inappropriate in this end-of-life scenario.
Choice B reason: Contacting the family to discuss the decision is unnecessary unless the client is incapacitated, which is not indicated. The client’s advance directives guide care, and family input is secondary to the client’s wishes, making this action incorrect and irrelevant.
Choice C reason: Discussing treatment options with the surrogate is inappropriate, as the client is competent and has clear advance directives refusing treatment. The surrogate’s role applies only if the client cannot decide, making this action misaligned with the client’s autonomy and directives.
Choice D reason: Discussing discharge options respects the client’s refusal of treatment and advance directives, focusing on palliative care or home arrangements. This supports autonomy and aligns with end-of-life care principles, ensuring comfort and dignity, making it the correct action.